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Intensive Care Medicine
Published in: Intensive Care Medicine 10/2018

01-10-2018 | Conference Reports and Expert Panel

White paper: statement on conflicts of interest

Authors: Julian Bion, Massimo Antonelli, LLuis Blanch, J. Randall Curtis, Christiane Druml, Bin Du, Flavia R. Machado, Charles Gomersall, Christiane Hartog, Mitchell Levy, John Myburgh, Gordon Rubenfeld, Charles Sprung

Published in: Intensive Care Medicine | Issue 10/2018

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Abstract

Introduction

Conflicts of interest are a normal part of human social intercourse. They become problematic when there is a power differential between participants in the setting of relationships requiring a high degree of trust, as in healthcare. In this white paper we consider how these conflicts may be detected and mitigated.

Methods

Following Medline search and reference chaining, we undertook a narrative review of the literature with iterative discussion.

Results

Conflicts of interest may be financial, professional or personal, and may operate at the level of the individual or the organisation. Unmanaged, they become a source of bias which places the interests of the professional or the organisation before those of the patient. Reported with increasing frequency, conflicts damage trust, harm patients, and defraud the health system. We make 15 recommendations for minimising conflicts of interest.

Conclusions

Nationally funded open-access registries should be established to permit complete disclosure of financial, professional, and personal relationships with the potential for driving bias in research, clinical practice, or health management. Governance of disclosure should be the responsibility of employing organisations through annual staff appraisals, audited by national research integrity committees. Research fraud should incur suspension of the license to practice. Organisations should monitor staff perceptions of ethical climate to enhance awareness of staff behaviours and the potential for misconduct driven by academic pressures. Clear separation of advisory and voting roles is needed in best practice guideline panels. Professional societies and scientific journals should display conflict of interest policies for their own staff and officers as well as for speakers and authors. Undergraduates should not be exposed to pharmaceutical promotions masquerading as education. Undergraduate and postgraduate training programmes should include teaching about managing conflicts of interest and identifying research misconduct.
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Metadata
Title
White paper: statement on conflicts of interest
Authors
Julian Bion
Massimo Antonelli
LLuis Blanch
J. Randall Curtis
Christiane Druml
Bin Du
Flavia R. Machado
Charles Gomersall
Christiane Hartog
Mitchell Levy
John Myburgh
Gordon Rubenfeld
Charles Sprung
Publication date
01-10-2018
Publisher
Springer Berlin Heidelberg
Published in
Intensive Care Medicine / Issue 10/2018
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI
https://doi.org/10.1007/s00134-018-5349-8

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